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Pulmonary Embolism | Nursing Care for PE Patient for NCLEX

Okay, let s talk pulmonary embolism. The chances of you getting a question about
pulmonary embolism on the actual NCLEX is pretty low. However, let s talk about the things you know
in case you encounter one of these questions. First of all, let s discuss what exactly is
a pulmonary embolism. Now, you re gonna hear pulmonary embolism
as P.E. if you re working in the hospital. You re just gonna be, you re just gonna know
it s P.E., that s we re basically gonna call it. Okay, so, what is a P.E.? Well a PE, first of all, it s pulmonary, okay,
so, that means lungs, and then it s called embolism. So, what s in an embolism? An embolus is a clot that breaks off and travels
through the blood stream. Okay, so what s gonna happen with the pulmonary
embolism is a clot is gonna break off, usually a DVT, something in the lower extremeties,
it s gonna break off, travel through the blood stream, into the right heart, an then into
the blood supply of the lungs. Okay, so, it s gonna get into the blood supply
of the lungs, and eventually, it s gonna get into a spot that it can no longer travel. So, it s gonna get into this spot that it
actually clogs off the blood supply to a portion of the lungs. And what s gonna happen there is you re gonna
have all this blood that s trying to get perfused, it s gonna try to reach this alveoli, and
gets perfused with oxygen and it s not going to be able to do so. Okay, so that s what a pulmonary embolism
is. Understanding what happens here and then we
re locking off that blood flow will help us understand what some of the different symptoms
are gonna be. Okay, so, for your assessment on your patient. First of all, it s gonna be anxiety. If you think about this, these patients aren
t able to profuse their blood and so, they re gonna become very anxious. They re gonna have tachycardia, tachypnea,
they re gonna be breathing very fast, possibly hypotension and a low grade fever, okay? They will probably have a cough, this dry
cough, they might have some hemoptysis with it, which means a little bit of blood in their
cough. Okay, they got this blood clot in there, they
might get a little blood with it. Those altered mental status, okay, decreased
level of consciousness. These patients are no longer getting the oxygen
that they need and so, they re neuro status is gonna change. They re gonna have diapheresis, you re gonna
notice a sweating on them, this anxiety, this change in the level of consciousness. You re also gonna notice VQ mismatch, ventilation
perfusion, this means the ventilation perfusion scan, and what s that gonna show you is basically
you re gonna see VQ mismatch. Okay, that s what you need to know with that. That s omething we can get into later. You re gonna notice extremely low PaO2, their
partial pressure of oxygen in their blood is gonna be very low, obviously, they re not
getting oxygen to the blood. Pulmonary angio is gonna actually possibly
show us the clot. Management. With this, we gonna need them, we need to
get them oxygen, we need to provide supplemental oxygen and be prepared for mechanical ventilation
if we re unable to get their PaO2 where we need it to be, then we need to offer them
mechanical ventilation. We re gonna offer them anti-coags to try to
decrease that coagulation in their blood and we re probably also thrombolytics at them,
probably some TPA, or something like that to break up that clot, to bust it, and to
get blood flowing how it needs to. Obviously, we re gonna get them opioids to
treat this pain that they re gonna be having and we need to give them anti-anxiety or anxiolytics,
to help calm them and feel that we re gonna be able to treat this and help them. Another thing that we re gonna do is vena
cava filter. What this is, we have our inferior vena cava
coming up from the lower extremities into the heart with the vena cava filter is it
just little tiny kinda metal shaped, cone, triangular shaped net that actually sits in
the inferior vena cava. So, you ll see this IVC filter, and what that
does, is that it s going to catch any clots that break off, they re actually gonna caught
in this little net and they will not be able to travel to the lungs. Okay, so that s an IVC filter is. So, here is a pulmonary angio, this is an
angiogram of, you re gonna see heart here, lungs, and this is what doctors may use to
be able to definitively diagnose PE. Okay, so, that s what we need to know about
PE mainly, anxiety, pain, and obviously, they re not gonna be able to breathe as they need
to. So, we need to break up that clot, we need
to prevent further clots, okay. So, guys, that s what you need to know about
PE. Be sure to subscribe to get more information
and more 2-minute RN videos, if you have any questions, you can email me [email protected] or . leave a
comment below. Thanks a lot guys!

7 thoughts on “Pulmonary Embolism | Nursing Care for PE Patient for NCLEX

  1. Hi there this was very informative.
    My question is wouldn't the opioid be contraindicative of the respiratory impairment or would it be give after thrombolysis, and/or filter insti tu and thereby respirations are normal …but then the pain due to ishemia would resolve….help.Might be over thinking

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